运动与饮食干预下肥胖儿童体重变化的能量平衡与失衡

发布时间：2018-05-20 14:10

本文选题：能量平衡 + 肥胖儿童　；参考：《北京体育大学》2017年博士论文

【摘要】：目的:基于能量平衡与肥胖理论提出两个研究假设,实验数据验证研究假设、探讨机体如何达到能量平衡的以及减体重与能量距的量效关系。运动与饮食干预下探讨能量平衡要素变化和肥胖儿童减体重效果。实验干预中止后,追踪观察能量平衡要素变化及其与体重维持的关系、探讨指标变化时序性特征。方法:选取北京某小学40名10-11岁肥胖儿童。为排除生长因素干扰,将其随机分为实验组和对照组:实验组运动与饮食干预,对照组空白对照。受试者周中三餐在校吃,营养师配餐并称量克数。周末三餐在家由家长称量记录、拍照上传至微信。运动干预5次/周,60mins/次。研究经3次基线测试、8周运动与饮食干预、4周追踪观察和半年后追踪测试,纵向追踪数据采用广义估计模型处理。结果:1控制成长作用,单纯实验干预作用下肥胖儿童减重4.83kg;RMR下降0.137 kcal/h/kg。2参数估计显示:减重3-4kg和减重2-3kg与RMR变化具有显著性;减脂4.5kg以上时,RMR与骨骼肌量呈显著正相关(r=0.226,P.05)。3腰围、臀围、大腿围1周见效,上臂围2周,小腿围4周;变化幅度:腰围上臂围臀围小腿围大腿围。4较高的EI水平上,低TEE与体重变化率呈显著反相关(r=-1.865);较高的TEE水平上,低EI与体重变化率有显著性。结论:1静息代谢率RMR的生理调节作用:减缓了减体重的速度。2调整EI或TEE获得3500kcal能量距,体重可以降低0.45kg的理论值不能准确表达实际体重变化。实测△E与体重变化率的量效关系为:?=3.833—1.299X△E1—0.920X△E2。当能量距在[-7.99,-379]kcal/d时,肥胖儿童体重下降2.5%;在[-380,-605]kcal/d时,体重下降2.9%。3在8周饮食和运动干预下,对于BMI等于26上下的10-11岁儿童,减体重2-4 kg是其RMR显著变化的减重区间。4运动与饮食干预下增加骨骼肌量以提高RMR,需在脂肪减少较大(4.5kg)的前提下实现。5肥胖儿童围度变化最明显的是腰围和上臂围,大腿围变化最不明显。6高能量流通量驱动下,体重不容易增加;低能量摄入低能量消耗体重容易增加。
[Abstract]:Aim: based on the theory of energy balance and obesity, two hypotheses were proposed, and the experimental data were used to verify the hypotheses, and to explore how the body achieves energy balance and the dose-effect relationship between weight loss and energy distance. To explore the changes of energy balance factors and the effect of weight loss in obese children under the intervention of exercise and diet. After the termination of experimental intervention, the changes of energy balance factors and their relationship with weight maintenance were observed, and the temporal characteristics of index changes were discussed. Methods: 40 obese children aged 10-11 years were selected from a primary school in Beijing. In order to eliminate the interference of growth factors, it was randomly divided into experimental group and control group: exercise and diet intervention in experimental group and blank control group. The subjects ate three meals at school in the middle of the week, and dieticians ordered meals and weighed grams. The three meals were recorded at home by parents and uploaded to WeChat. Exercise intervention 5 times a week, 60 mins per week. Three baseline tests were conducted for 8 weeks exercise and diet intervention for 4 weeks and half a year later. The longitudinal tracking data were processed by generalized estimation model. Results the weight loss of obese children was decreased by 0.137 kcal/h/kg.2 under the control of 1: 1. The parameters of weight loss 3-4kg, 2-3kg and RMR were significantly different when the weight loss was higher than 4.5kg, and there was a significant positive correlation between RMR and skeletal muscle volume in obese children under the intervention of 4. 83kg / kg. 05. 3 waist circumference. Hip circumference, thigh circumference 1 week, upper arm circumference 2 weeks, calf circumference 4 weeks. Range of change: waist circumference, upper arm circumference, hip circumference, thigh circumference, low TEE were significantly correlated with body weight change rate. Low ei and weight change rate were significant. Conclusion the physiological regulation of resting metabolic rate (RMR) of 1: 1: decrease the speed of weight loss by adjusting ei or TEE to obtain the energy distance of 3500kcal, and the theoretical value of weight can not accurately express the change of actual weight. The dose-effect relationship between the measured E and the weight change rate was 3.833-1.299X E1-0.920X E2. When the energy distance was at [-7.99 ~ 379] kcal/d, the weight loss of obese children was 2.5, and at [-380-605] kcal/d, the weight loss was 2.9. 3 for children aged 10-11 with BMI equal to about 26 after 8 weeks of diet and exercise intervention, Weight loss of 2-4 kg was the significant change of weight loss interval of RMR. The waist circumference and upper arm circumference of obese children were the most obvious changes of waist circumference and upper arm circumference under the intervention of diet and diet to increase skeletal muscle volume in order to increase RMRs. The most obvious changes in circumference of obese children were waist circumference and upper arm circumference when fat loss was larger than 4.5 kg. Under the driving of high energy flux, the body weight is not easy to increase, and the weight of low energy intake and low energy consumption is easy to increase.
【学位授予单位】：北京体育大学
【学位级别】：博士
【学位授予年份】：2017
【分类号】：G804.2

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